The Sweeter Side of Sugar Substitutes // A Deeper Look At Xylitol

Navigating the sugar substitute world can be confusing and misleading. We know that artificial sweeteners are off the table - but what about natural sweeteners and sugar alcohols?

We know with certainty that that too much sugar is bad for you, and most Americans consume way more than they should. According to Dr. Robert Lustig, a pediatric endocrinologist at the University of California in a Time magazine article:

“Your liver can process roughly six to nine teaspoons a day without significant issue,” Lustig says. “The average American consumes 19.5 teaspoons a day.” And while honey may contain antioxidants or compounds that, on their own, may offer some benefits, “The sucrose in honey is still sucrose,”

Food based options such as dates, honey, maple syrup, and coconut sugar are great, but on a metabolic level they still have a negative effect on blood sugar spikes. When we move to low-carbohydrate options most of you are probably familiar with steviawhich is derived from the Stevia rebaudianaplant however you may not like the strange aftertaste it leaves.

We thought is was important to take the time to highlight the most relevant and recent information regarding xylitol’s safety and effectivity profile since we use it as an ingredient in our own Drinking Chocolate!

Make yourself a cuppa tea and settle in!

Q: What is xylitol?

Today, xylitol has been extremely well researched with around 1,500 published studies. Xylitol has been used as a sweetening agent in human food since the 1960’s and is largely used in Europe as a sugar alternative. Xylitol is currently approved for use in foods, pharmaceuticals, and oral health products in more than 35 countries.

Xylitol is a sugar alcohol, which is a low-digestible carbohydrate that resists starches and includes fiber that can be found in a very small quantity in fruits such as plums, strawberries, and raspberries and vegetables such as cauliﬂower, pumpkin, and spinach (1). Humans even produce small amounts of it via normal metabolism. It is a common ingredient in sugar free chewing gums, candies, mints, diabetes friendly foods and oral care products. The glycemic index (a measure of how quickly foods raise blood sugar) of xylitol is only 7, compared to regular sugar, which has a glycemic index of 60-70) (2).

Currently the two largest sources of xylitol are corn cobs and birch bark. Our xylitol is produced from non-GMO corn cobs which are seen asa more environmentally friendly source compared to birch bark. Corn cobs are a renewable resource each year and help to reduce perceived waste creating a lowered environmental impact.

The actual extraction process is also different depending on the initial source. The corn cob source uses a natural ion-exchange interaction of hydrogen, hydrochloric acid, and steam. The waste water from this process is used for mushroom farming adjacent to the factory itself, and the pulp is used for fuel. The birch bark source xylitol uses the same process, but uses sulfuric acid in place of hydrochloric acid. This creates a waste product which is not suitable to be reused in any other manner.

Q: How do humans digest/metabolize xylitol?

It has been demonstrated that the body does not require insulin to metabolize xylitol(Cao et al., 1994). For this reason polyols like xylitol produce a lower glycemic response than sucrose or glucose. This has made xylitol a widely used sweetener for the diabetic diet in some countries.

Xylitol is incompletely absorbed, and only a portion of what is absorbed slowly converts to glucose. The unabsorbed xylitol acts as a prebiotic similar to dietary fiber, helping to maintain healthy gut function. About two-third of ingested xylitol is metabolized by intestinal bacteria which exerts prebiotic effects by producing SCFAs, lowering blood glucose, cholesterol, and triglyceride levels (3).

After xylitol absorption in the blood stream, liver uptake of xylitol is insulin independent and causes very little increase in blood glucose, insulin, and glucagon levels. The liver is the major organ used for the removal of xylitol from the blood stream and metabolizes 50–80%. The remaining 20% of xylitol can be metabolized by the lungs, kidneys, fat stores, erythrocytes, and myocardium (4). These metabolized products can thus be converted into carbon dioxide and water by the normal physiologic conditions of carbohydrate metabolism.

Q: Does xylitol disrupt digestive health or our healthy gut bacteria?

Animal studies have found that xylitol causes a shift from gram-negative to gram-positive bacteria, with fewer Bacteroides and increased levels of Bifidobacteria. (5, 6) A similar shift has been observed in humans, even after a single dose of xylitol (6). Additionally, the shifts observed allowed for more efficient use of the sugar alcohols by gut bacteria, which largely explains the reduction in GI symptoms after a few months of regular consumption.

Q: What are the safety concerns regarding xylitol?

As with anything, moderation is key. Ingesting large quantities of xylitol in humans (20g +) have shown to produce digestive upset, gas, bloating, and/or diarrhea. There is less than 2g of xylitol present in each serving size of our Drinking Chocolate. In one study, subjects consumed an average of 3.3 lbs (1.5 kg) of xylitol per month, with a maximum daily intake of over 400 grams without any negative effects (7).

Also to note is that xylitol should be kept away from any pets in the home and is not deemed safe for dogs as they metabolize it differently than humans.

Q: What are some of the positive health benefits of xylitol?

Xylitol is a prebiotic sweetener which can modify the colonic microorganisms and enhance the growth of health promoting bacteria, particularly biﬁdobacteria and lactobacilli (8). The primary beneﬁt of the enhancing colonic lactobacilli and biﬁdobacteria is a protection against infectious intestinal diseases and cancer by reducing the putrefactive bacteria (such as Clostridium perfringens) and pathogenic bacteria (such as Salmonella, Listeria, Escherichia coli, Shigella, and Clostridium difﬁcile).

Xylitol has also been proven to inhibit the growth of harmful bacteria. Research shows that this effect enables xylitol to help prevent bacteria and irritants from adhering to upper respiratory passages when used as a nasal wash or oral rinse (9).

Xylitol has shown to improve diabetes and carbohydrate sensitivity. Advantages of using xylitol to improve blood sugar control include:

Final thoughts:

Xylitol has a safety profile that has been well documented in humans and proves to be a safe and effective alternative to sugar and artificial sweeteners. As with everything, we don't encourage over consumption! Remember that xylitol should still be used in moderation.

If you're looking to read more on the subject of sugar alcohols Chris Kresser did a fantastic job in his article here.Also, if you just made it through that whole article I want to personally commend you for taking the time to digest some serious reading!